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State v. Nelson

Court of Criminal Appeals of Tennessee, Jackson

May 5, 2015


Session: Date January 6, 2015

Appeal from the Circuit Court for Lauderdale County No. 9132 Joseph H. Walker, III, Judge

A Lauderdale County jury convicted the Defendant-Appellants, Gregory Nelson and Tina Nelson, of the charged offenses of first degree felony murder during the perpetration of aggravated child abuse and aggravated child abuse. Tina Nelson was sentenced to life imprisonment for the first degree felony murder conviction and to fifteen years for the aggravated child abuse conviction, and Gregory Nelson was sentenced to life imprisonment for the first degree murder conviction and to twenty years for the aggravated child abuse conviction. In this consolidated appeal, Gregory[1] and Tina Nelson argue that the evidence is insufficient to sustain their convictions. Upon review, we affirm the judgments of the trial court.

Tenn. R. App. P. 3 Appeal as of Right; Judgments of the Circuit Court Affirmed

James E. Lanier, District Public Defender; and David S. Stockton, Assistant Public Defender, Somerville, Tennessee, for the Defendant-Appellant, Gregory Nelson.

Lyle A. Jones, Covington, Tennessee, for the Defendant-Appellant, Tina Nelson.

Robert E. Cooper, Attorney General and Reporter; Jonathan H. Wardle, Assistant Attorney General; D. Michael Dunavant, District Attorney General; and Julie K. Pillow, Assistant District Attorney General, for the Appellee, State of Tennessee.

Camille R. McMullen, J., delivered the opinion of the court, in which Alan E. Glenn and Roger A. Page, JJ., joined.



The victim, E.N., [2] Gregory and Tina Nelson's two-and-a-half-month-old daughter, died on May 11, 2011. At the time of her death, the victim had brain hemorrhages, a retinal hemorrhage in one eye, optic hemorrhages behind both eyes, and multiple broken ribs. The autopsy report stated that the victim's cause of death was homicide from a closed head injury and that the victim's numerous injuries were not from natural causes. Gregory and Tina Nelson, who were unable to sufficiently explain the cause of the victim's extensive injuries, were subsequently indicted for first degree felony murder and aggravated child abuse.


William Freeman, an emergency medical technician (EMT), testified that on May 11, 2011, he responded to a call from the Nelsons' residence that their infant was not breathing. The original call came in at 7:07 a.m., and the ambulance arrived at the Nelsons' home at 7:18 a.m. When Freeman arrived, Tina Nelson handed him the victim, who was "obviously lifeless[.]" He and another EMT took the victim to the ambulance to conduct CPR, place her on a monitor, and evaluate her. They ventilated the victim for several minutes until they determined that she had died. During this time, the victim never had any cardiac activity and never took a breath. Freeman said the victim had nothing blocking her airway. He was surprised to learn that the victim was two and a half months old because she appeared to be substantially younger based on her size.

Freeman stated that Tina Nelson was "pretty much hysterical" when he first made contact with her. Once he and the other EMT disclosed that the victim had passed away, Mr. Nelson became upset because he thought they "should have gotten there sooner" and "had to be restrained by one of the Haywood County officers." Freeman stated that as they were working on the victim, neither Tina nor Gregory Nelson ever came to the ambulance to check on her. Once he informed them that their baby had passed away, the Nelsons' family arrived. At that point, Gregory and Tina Nelson went to a family member's car, where they were "smoking cigarettes, laughing, cutting up, just as though nothing had happened." He described their behavior as "unusual." He stated that the Nelsons never asked to see the victim while he was at their residence.

Steve Sanders, the Sheriff of Lauderdale County, testified that he was also present at the Nelsons' home on May 11, 2011. He described Gregory's and Tina's demeanor as calm. Tina told him that the victim, upon waking, began crying and that she got her out of the crib and placed her on the mattress on the floor. She fixed a bottle, gave it to the victim, and walked away. When she returned, the victim was unresponsive. She then screamed to her husband, Gregory Nelson, and he made the 9-1-1 call. Tina also told Sheriff Sanders that they noticed the victim breathing heavily around 8:00 p.m. the previous night. When he examined the victim's body, he noticed a red mark that appeared to be a birth mark on the victim's lower back but did not see any bruises or any other marks.

Cheryl Manns, the custodian of the records at the Lauderdale Community Hospital, testified that the hospital's records showed that the victim, who was dead on arrival at the hospital, had been suffering from a cold for the last two days, had experienced decreased appetite, and had been taking amoxicillin that had been prescribed by a physician. The records also showed that the victim stopped breathing because she began choking during a feeding and that the victim's father attempted CPR. The records noted a "small scab defect to [the victim's] right nose." They also contained the following information about the victim: "Recently seen, treated by doctor. EMS called at 7:07 [a.m.]. Per family states child not breathing at 6:45 [a.m.]. Called family first to get car, then called EMS." Manns conceded that she could not testify as to whether the information contained in the hospital's records was true or false, only that this information was found within the records.

Dr. Miguel Laboy, a medical examiner for the Shelby County and West Tennessee Regional Forensic Center, testified as an expert in the field of forensic pathology. Dr. Laboy stated that he performed the victim's autopsy on May 12, 2011, the day after her death. After performing an external examination, Dr. Laboy determined that the victim, who was two-and-a-half months old at the time of her death, weighed 6.5 pounds and was small for her age. He also observed a very small abrasion on the victim's nose and a half-inch by quarter-inch dark brown bruise under her right jaw. He stated that it was unusual to see a bruise under the jaw of an infant because that is a not a prominent area of the body, explaining, "[If] someone drop[s] her or they fall and [get] scrape[d], usually they're going to hit the prominent things like the forehead or the eyebrows or the cheeks, the sides of the jaw. [The area under the jaw is] an area that's kind of protected[.]"

Upon conducting the internal examination, he did not find any evidence of bruises on the victim's scalp. However, he did find "a thin layer of subdural hemorrhage in the right inner aspect with blood clots and yellow-green coloration, " as well as a "hemorrhage on the left side with also yellow or golden coloration." In addition, he observed a "a patchy subarachnoid hemorrhage and yellow discoloration obvious on the right parietal lobe [at the top of the victim's head]." He explained that there was blood accumulation between the thick membrane under the skull and the brain. There were also patchy areas of the brain that had different blood accumulations. He said the areas of "yellow-golden discoloration" were caused by multiple bruises that had occurred in the past. He also found subdural hemorrhages that were recent injuries that showed "yellow-golden" and "yellow, orange, golden" on the parietal lobe. These subdural hemorrhages showed "areas of recent bleeding and old bleeding that was reabsorbing." He also saw areas of recent bleeding and old bleeding that were reabsorbing in the subarachnoid hemorrhage, which was on the back of the brain.

Dr. Laboy stated that although there could be natural or traumatic causes for hemorrhages of this type, he did not find any natural causes for the victim's brain hemorrhages and concluded that they were from a "traumatic injury." He also reviewed the victim's medical records and found nothing that would indicate that these hemorrhages were from natural causes.

In addition to the victim's brain hemorrhages, Dr. Laboy found recent "perioptic hemorrhage[s]" between the sheath and the optic nerve of both eyeballs. He stated that perioptic hemorrhages are caused when there is a traumatic injury that increases the pressure, causing the brain to collapse and blood to accumulate in that area. In addition, he noted that the victim's left eye had a recent retinal hemorrhage, a hemorrhage inside the eye, that was also caused by traumatic injury. Dr. Laboy did not find any solid mass that could have caused the victim to choke. He said that liquid, like milk or formula, would not cause a choking death in an infant, although it might cause the infant to cough, throw up, or react in some way. There was no visible milk in the victim's lungs or bronchial tubes, and there was no evidence that the victim suffered a choking death.

Dr. Laboy also examined the victim's skeletal system and found healing fractures on six ribs on the left lateral side and healing fractures on eight ribs on the left posterior side. He also found healing fractures on five ribs on the right lateral side. Dr. Laboy stated that these fractures were healing with calluses, and there was a recent refracture in the ninth left posterior rib with blood around it. He asserted that posterior refractures in infants are "more consistent with some inflicted trauma" rather than accidental trauma and that the victim's fractured ribs were consistent with a squeezing type of inflicted trauma. Because the rib fractures were in the process of healing, he concluded they were probably less than a month old. Dr. Laboy acknowledged that because all the rib fractures, except the most recent fracture, looked microscopically the same, they could have been the result of a single event. He opined that the victim's bones were normal and not brittle.

When Dr. Laboy examined the victim's lungs, he found that the victim had chronic bronchiolitis that had been going on for weeks. He also determined that the victim had a recent pneumonia occurrence that had been going on for the last day or few days. He explained that multiple rib fractures cause pain, which can affect breathing and can make a person more likely to develop pneumonia. Dr. Laboy also stated that an infant with a brain injury is more likely to develop pneumonia.

Dr. Laboy concluded that the bruise underneath the victim's jaw was a recent injury because his examination of that area did not show any "recent breakdown of the red blood cells[.]" However, he acknowledged that administering CPR on a dead body could cause a bruise by impacting, stretching, or pinching an area by artificially making the heart pump.

Dr. Laboy opined that the victim's cause of death was a closed head injury. He explained that death results from a closed head injury when the inflammation becomes so great that it damages the brain. While he noted that an infant can survive trauma to the brain, in this case, the victim had evidence of an old brain injury and then a rebleeding over that area that likely caused the victim's death. He stated that the victim could have had an aneurysm, a seizure, or could have died from an inability to get oxygen because of a problem in the lungs. He stated that it was unlikely that the victim's brain injuries were more than a month to a month and a half old.

Dr. Laboy noted in his report that "the finding of rib fractures raises the index of suspicion that the acute intracranial hemorrhage is traumatic in nature." After reviewing the victim's histology, cultures, rib fractures, toxicology reports, and after consulting with a neuropathologist, Dr. Laboy concluded that the brain hemorrhages and retinal hemorrhages were not from natural causes. He stated that his autopsy was more accurate than either an MRI or an Ultrasound. Dr. Laboy opined that the areas showing reabsorption of blood on the subarachnoid space had been there longer than two or three days but not longer than a few weeks. He also stated that there were areas of recent hemorrhaging in the subarachnoid space. He acknowledged that there was no bruising on the scalp, no skull fractures, and no upper neck injuries. While he admitted that there could be natural causes for a subdural hemorrhage or subarachnoid hemorrhage, he did not see any evidence that these injuries were from natural causes. He said that natural causes for these hemorrhages would include a vascular malformation that breaks and bleeds into the subarachnoid space or subdural space, tumors that bleed out to these areas, tumors in the dura that bleed, problems with coagulation, and mutations that affect the brain. Dr. Laboy acknowledged that Tina Nelson would not have known about these brain hemorrhages because they were internal injuries. He also acknowledged that the hemorrhaging around the victim's perioptic nerve would not be visible to Tina Nelson because a person would have to dilate the eye and look inside it to see these injuries.

When asked if the victim's posterior rib fractures could have occurred if someone was holding the victim and fell or was knocked down, Dr. Laboy stated, "The scenarios can be multiple, so you have to give [me] more specific [details], where they land, how they fall, one side, front, actually bending the arms and crushing the infant." When asked if he knew how the rib fractures occurred, Dr. Laboy stated that the fractures "were from any trauma that compressed [the ribs] and fractured [them]."

Dr. Laboy acknowledged that at the time of the autopsy, which was one day after the victim's death, there were no external signs of force or trauma on the victim's head. However, he said that if an infant were thrown forcefully onto something soft, like a mattress on the floor, it would not be unusual not to see any external bruising. He also stated that it was possible for the victim to have had external bruising when these injuries occurred, and these bruises had healed over time. Dr. Laboy noted that when the treating physicians performed an MRI on the victim, the results were normal. He added that the symptoms of seizures, respiratory problems, lethargy, and loss of appetite would be indicators that a parent should take the child to a doctor or to the emergency room.

Pat Harwell, the custodian of records for the Jackson-Madison County General Hospital, testified that the victim was admitted to the hospital on February 21, 2011, and was discharged on March 7, 2011. The social service notes stated that Tina Nelson, who appeared "mildly mentally retarded, "[3] had "been disabled since birth and receive[d] SSI." The report also noted that Tina Nelson's husband, Gregory Nelson, "appear[ed] somewhat developmentally delayed but state[d] he [was] not disabled." The notes showed that Tina and Gregory Nelson had a "five-year-old daughter, [B.N., ]" who lived with them and that Gregory Nelson's severely mentally retarded brother also lived with them. The parents disclosed that they had no income other than the social security disability checks and the money that Gregory earned from odd jobs around town and that neither one of them was able to drive. The reports showed that Tina Nelson could not read or write.

The reports from February 23, 2011, showed that Gregory Nelson had said he and Tina needed to return home as soon as possible because their family was fighting in their father's home where their five-year-old daughter was staying. Transportation was notified to take Tina and Gregory Nelson home that morning. The Department of Children's Services (DCS) was given a "verbal referral requesting a home evaluation prior to [the victim's] discharge" from the neonatal unit and requesting a "safety plan."

The reports from February 24, 2011, stated that Gregory Nelson informed the staff he would be unable to receive training and teaching because they had no family to keep their five-year-old child while they were at the hospital. The staff member noted that she was concerned about Gregory Nelson not attending the training because Tina Nelson was illiterate. This staff member contacted Zandra Carter-Mann, a DCS worker in Lauderdale County, who stated that she knew the Nelsons. She "made arrangements for [a] child-family team meeting" with the parents and asked that the staff member and the neonatal nurse participate in the meeting over the phone.

The reports from March 2, 2011, showed that after conducting the team meeting over the phone, "it was determined by DCS that [the] mother, father will be required to visit and bond with newborn at least two times a week prior to the time to start rooming in." DCS planned to monitor Tina's and Gregory's visits with the victim. The reports from March 4, 2011, established that Tina and Gregory Nelson arrived at the Neonatal ICU at 8:00 a.m. to stay the weekend and that they had "positive involvement with the newborn[.]"

Harwell acknowledged that the victim had been diagnosed with "intrauterine growth retardation, " which meant that the victim had not grown at a normal rate inside the womb. She stated that one of the treating physicians ordered a cranial ultrasound for the victim, and another physician ordered an MRI. The victim's cranial ultrasound showed "[n]o gross evidence of intracranial hemorrhage" and listed the following as an "impression":

Contour irregularity in the roof of the left lateral ventricle is nonspecific. This may be an unusual location for hemorrhage. This could be a soft tissue nodule versus maybe ectopic grey matter. Follow[]up examination is recommended.

The nursing notes from March 4, 2011, stated that the victim's heart rate dropped to 62 beats per minute. When the nurse explained that the drop in the victim's heart rate could extend her stay at the hospital, Tina and Gregory Nelson stated that they could not afford to repeatedly make trips to the hospital.

Zandra Carter-Mann, an employee at the Lauderdale County DCS, testified that she received a referral from the Jackson-Madison County Hospital regarding the victim and the victim's five-year-old sister. The hospital staff were concerned about whether Tina and Gregory Nelson would be able to meet the children's needs. Because the victim was born prematurely, the staff wanted the parents to be trained on CPR and wanted to ensure that they knew what to do if the victim had respiratory problems. She explained that in these situations, the parents must receive training before the infant is discharged from the hospital. Carter-Mann stated that after Tina Nelson was discharged from the hospital on February 23, 2011, neither she nor Gregory Nelson visited the victim and claimed they could not visit because they did not have transportation and were unable to find someone to care for their five-year-old child. As a result, DCS informed the Nelsons that they would have to visit and bond with the victim and learn to care for her before DCS would allow the victim to go home with them.

Carter-Mann stated that she met with Tina and Gregory Nelson at the Nelsons' home on February 24, 2011, to inform them of the things they needed to do in order to take the victim home and to assess whether they had the necessary supplies in order to properly care for her. At the time, Gregory Nelson was upset because he did not understand why DCS was involved. Carter-Mann was aware that Gregory Nelson had previously become aggressive with the hospital staff. She stated that the Nelsons had baby supplies that had been donated by a church but did not yet have a car seat that was the right size for a premature baby.

While Carter-Mann acknowledged that Tina Nelson was developmentally delayed, she said Tina was able to sign DCS paperwork, to participate in meetings, and to schedule appointments for her children. Carter-Mann stated that if Tina Nelson had told the hospital staff that she could not read or write, this information was inaccurate based on her interaction with her. She believed that when Tina and Gregory Nelson worked together, they were capable of taking care of the victim and their older child. During her meetings, Gregory Nelson often became upset and verbally aggressive and would state that he was going to refuse to answer questions. He would also tell his wife not to answer their questions, and she would comply. Tina would defend her husband's aggressiveness and would provide excuses for why they were unable to do the things DCS asked of them.

After the February 24, 2011 meeting, Carter-Mann tried to visit with the Nelsons every two weeks so that she could assist them with anything they needed. During these unannounced visits, she entered the Nelsons' home. Carter-Mann stated that the Nelsons did not allow their children to be kept by family members and that Gregory was combative and did not have a good relationship with his family. She could not recall a time that the victim stayed with anyone other than Tina and Gregory Nelson. During her visits, the victim was always dressed appropriately and was always sleeping. At her last visit, she noted that the victim was gaining weight.

In April 2011, a juvenile court staff member notified DCS about some concerns they had about the victim. Carter-Mann conducted a home visit the next day, and the Nelsons agreed to take the child to the pediatrician to ensure that there was nothing seriously wrong with her. During her home visits with the Nelsons from February until early May, the only individuals living in the home were Tina and Gregory Nelson, their older daughter, and the victim. Carter-Mann never saw any evidence of others living in the home.

Carter-Mann acknowledged that on May 14, 2011, she wrote the following report regarding her last visit with the Nelsons after the victim's death:

Assessment worker, Zandra Carter-Mann, went to the home to check on the family after [the] loss of their daughter, [E.N.]. Mr. Nelson stated that he was doing well and Tina was still in bed. AW Carter-Mann asked him what happened.
He reported [that] they had noticed for a couple of days the baby wasn't feeling good and had taken her to the doctor as they told me they would. Mr. Nelson stated that he was holding the baby when she began to spit up through her mouth and nose. He said he took the suction and cleaned her mouth and nose. He said he began to notice that she started changing colors.
Mr. Greg said Ms. Tina was putting . . . [their older daughter] on the bus, and he went to the door and told her to bring the cell phone so he could call the ambulance. Mr. Greg said he did CPR on the baby until the ambulance arrived, and once there, they started CPR. Mr. Greg said once they got to the hospital [E.N.] was pronounced dead.
Mr. Greg said he really didn't know what to do about funeral arrangements but donations were being taken up in the community. Mr. Greg said Enon, a church on Edith-Nankipoo, had paid for her a plot in full. Mr. Greg said [their older daughter] would be with his dad until they were feeling better.
Ms. Tina eventually came out and told worker a story that was consistent with Mr. Greg. AW Carter-Mann thanked the family for talking to her and told them to call if they needed anything.

Carter-Mann stated she knew that the Nelsons, including their older daughter and the victim, were supported by Tina Nelson's disability check of $627 a month and that the Nelsons did not own a car and did not have drivers' licenses. During her home visits, the Nelsons had adequate food for themselves and their children. She said that Gregory Nelson had a brother, Timothy, and that Gregory and Timothy had made allegations through DCS against each other regarding the safety of Tina and Gregory Nelsons' children. Carter-Mann said that although Timothy was staying with the Nelsons for a period of time, he left before the victim came home from the hospital. She noted an incident when Gregory Nelson became verbally aggressive with a school employee regarding a problem involving his older daughter and later called back and apologized. While she acknowledged that Gregory often became verbally aggressive with the DCS workers, she said there was never a time when he became physically aggressive with anyone from DCS. She also stated that Tina Nelson had never been physically aggressive with anyone from DCS.

Carter-Mann stated that it was her opinion that the Nelsons were able to take care of the victim's needs. She said the Nelsons received training from the hospital about administering CPR and caring for premature infants. She said it was not part of her job responsibilities to review the training the Nelsons received at the hospital.

She said that the Nelsons never told her they had trouble determining when the victim's next feeding needed to occur. Although she never saw the Nelsons feeding the victim because the victim was always asleep, Gregory Nelson talked to her about putting cereal in the victim's bottle. She told Mr. Nelson that the baby was not old enough for cereal but interpreted his comment to mean that the victim was eating rather than not eating. Carter-Mann said that her last home visit with the Nelsons before the victim's death was on May 3, 2011, or May 4, 2011. She also visited them after the victim's death on May 14, 2011. She stated that the Nelsons appeared to be bonding with the victim during her visits.

Carter-Mann admitted that she may have only made four or five home visits with the Nelsons prior to the victim's death because she tried to visit them every two weeks. She said that DCS had never discussed Tina Nelson's intellectual delays and was not aware of her intelligence quotient (IQ). Carter-Mann completed a closing safety assessment on May 27, 2011, wherein she stated that she had no safety concerns regarding the Nelsons' older daughter following the death of the victim. Carter-Mann said she had personally observed Tina Nelson caring for her children and had never believed it was appropriate to remove the children.

Carter-Mann drafted her closing safety assessment before receiving the results from the victim's autopsy. Once she received the autopsy report, DCS reopened the case, and the Nelsons' older daughter was removed from their home in August 2011. Carter-Mann stated that DCS did not conduct psychological evaluations of the Nelsons because she did not find they had any mental impairment that would warrant a psychological evaluation. When she told Gregory Nelson that he needed to find a job because he was physically able to work, he became angry and told her that DCS could not make him work, and Tina Nelson supported Gregory Nelson's desire not to work. She said that there were several times when Gregory became verbally aggressive with her over issues related to the victim, and Tina always sided with her husband. She said that Tina Nelson never disagreed with Gregory Nelson during the four or five years that she knew them.

Kim Coffee, an employee at the Lauderdale County Juvenile Court and the chairman of the truancy board, testified that she saw the victim prior to her death on May 11, 2011. She said that on April 20, 2011, the Nelson's older daughter had a truancy case before the board. After this case was heard, she learned that the Nelsons and their children had been standing outside in fifty-degree weather for two or three hours while they were waiting on a ride home. Coffee said that she became very upset with the Nelsons because the victim was dressed only in "very lightweight clothing and a very lightweight blanket" at the time. Coffee stated that she was present when Dawn Hemby, an investigator with the juvenile court, observed a red spot on the victim's right eye. When the Nelsons were asked about the victim's eye, they replied that the victim was "fine" and that they had already "had it checked on." Coffee said that when she gave the Nelsons a ride home that day, she was concerned because the victim "just stared into space" and "showed no emotion." She said the victim "didn't smile, she didn't laugh, she [had] no emotion whatsoever." She contacted DCS about her concerns regarding the children.

Approximately two weeks after April 20, 2011, Coffee said she received a call from a person she knew, who asked to remain anonymous, stating that the Nelsons were beating their older daughter. She and Dawn Hemby went to the Nelsons' home for a welfare check. The Nelsons, who were outside their home, stated that they had not beaten their older daughter and that she was currently at Gregory's father and stepmother's home. When they located the Nelsons' daughter, they did not observe evidence of any injuries. Coffee stated that she never saw the victim when she spoke to the Nelsons outside that day.

Coffee stated that after the dependency and neglect case had been filed regarding the Nelsons' older daughter, she went to the Nelsons' home to pick them up for a pre-trial conference with their court-appointed attorneys. Although Tina Nelson knew Coffee was giving them a ride, Gregory Nelson was not aware of it, and he was "hollering and screaming" about having to leave even after she told him he did not have to attend. Gregory eventually got into her car although he continued to yell and act "out of control almost." She said that he was "just fussing, saying he had never harmed that child, and he accused his brother of being the one to report it." Although Coffee had interacted with Gregory Nelson in the past, this incident was the angriest she had ever seen him. Coffee conceded that Gregory had never been physically abusive to her. She stated that Tina Nelson was upset because she thought that Gregory Nelson's anger was directed as much toward her as it was toward Coffee because she had asked Coffee to give them a ride.

Dawn Hemby, a youth services officer with the Lauderdale County Juvenile Court, testified that she had known Gregory Nelson through his own juvenile proceedings and had gotten to know Tina Nelson when the Nelsons' older daughter had a case before the truancy board on April 20, 2011. Hemby stated that she voiced her concerns about the victim to Lotoya Ward, an employee of DCS who was also on the truancy board. Ward informed her that DCS had already opened a case on the Nelsons' children. Hemby said that approximately two or three hours later, someone in the juvenile court office notified her that the Nelsons had been standing outside in low fifty-degree weather with the victim and their older daughter, and she and Coffee asked them to come inside the building. Hemby said that Coffee asked them why they were standing outside, and Gregory Nelson told them that they were afraid they would miss their ride. Coffee agreed to give them a ride home, and Hemby asked to hold the victim. As she was holding her, she noticed that the victim had "a blood spot" on the white part of her right eye. When she asked Tina Nelson what was wrong with the victim's eye, Tina said, "[T]he doctor said it's nothing." Hemby told her she needed to get a second opinion because it was not normal for an infant to have a blood spot on her eye. She said the victim was "[a]lmost lifeless" when she was holding her because the victim was not crying, cooing, or smiling. Hemby said she and Coffee took the Nelsons back home, and when she returned to the courthouse, she contacted Zandra Carter-Mann about the blood spot on the victim's eye.

Hemby stated that she believed that Tina Nelson was "bullied by" Gregory Nelson. She said Tina Nelson appeared capable of taking care of her own affairs because she had recently asked her if there was a court order preventing her from visiting her older daughter, who had been placed with her grandparents. She stated that the last two or three times she had seen Tina, Gregory Nelson had not been with her. Hemby believed that Tina was capable of taking care of herself and her children:

I think [Tina Nelson] . . . may be just a little slow, but not non[-] functioning. I think she's capable-I don't know if she would be capable of . . . being able to take care of financial things. And I don't really know why I think that, but that's just the impression that I get of her, that Greg pretty much does that. But as far as her cooking or cleaning and taking care of the kids, yeah, I think she could [do that].

Hemby stated that when she went to Irene Nelson's to check on whether Tina and Gregory's older daughter had been physically abused, she carefully examined the child and determined that the anonymous call had been unfounded. In fact, the child told her that her father had not hit her and that her Uncle Timothy, Gregory's brother, was "just trying to start stuff." Hemby said the anonymous call to Coffee was the only time she had ever received a referral about Tina and Gregory Nelson abusing one of their children.

Teresa Simmons, a customer service representative in charge of medical records with MedSouth Medical Center, testified that Dr. Randy Isaacs, a pediatrician in that medical group, treated the victim four times on March 9, 2011, March 16, 2011, March 30, 2011, and April 13, 2011. On March 9, 2011, Dr. Isaacs saw the victim as a new patient for her two-week physical. On March 16, 2011, Dr. Isaacs conducted a weight check on the victim and determined that the victim needed a hearing test. He noted that the victim appeared to be "[w]ell developed, well nourished, well hydrated." Dr. Isaacs noted that the victim had low body heat and weighed three pounds, four ounces when she was born. On March 30, 2011, Dr. Isaacs checked the victim's weight and discussed the victim's fussiness, spitting up, and the use of gas drops. On April 13, 2011, Dr. Isaacs noted that the victim was wheezing, frequently spitting up, and fussy in the afternoon and that he believed the victim might have thrush.

The office records showed that the Nelsons called Dr. Isaacs's office on March 21, 2011, because the victim had been having gas. A nurse returned that call and suggested that they give the victim Mylicon drops and told them to return to the office if the problem worsened. The Nelsons also called the office on April 6, 2011, because the victim had been spitting up her formula. A nurse returned this call, but the Nelsons did not answer.

Bridget Worlds, the custodian of the records for the Lauderdale County Health Department, testified that the records from March 10, 2011, noted that the victim's parents had "disabled mental capabilities, but seem[ed] to understand infant care and formula prep." On April 7, 2011, Gregory Nelson told a social worker at the health department that he believed something was wrong with his daughter because she was breathing strangely and spit up often. He believed that the victim's formula did not agree with her. The social worker encouraged Gregory Nelson to take the victim to the doctor if he believed she was not well. On April 28, 2011, Tina Nelson told a social worker that they were supposed to take the victim to the doctor on April 27, 2011, but that it was raining and too cold to take her out, so she planned to reschedule the appointment. Tina said the victim still spit up some and that when she took the victim to Dr. Isaacs's office the previous week, he prescribed medicine for the victim's ear infection. Tina and Gregory Nelson said that they were concerned about the victim's stools and were giving her some apple juice that helped this problem. On May 4, 2011, approximately a week prior to the victim's death, the victim weighed 7.2 pounds and had no known allergies, fever, or illnesses. A nurse on that date determined that the victim's eyes were "normal" and that the parent-child interaction was "good." The nurse also determined that the victim's fontanels and musculoskeletal system were normal. The health department's records showed that social workers from the HUGS program conducted home visits with the Nelsons on March 24, 2011, April 7, 2011, and April 28, 2011.

Joe Pursell, a Lauderdale County juvenile investigator, testified that after he received the autopsy stating that the victim's cause of death was homicide, he interviewed Tina and Gregory Nelson on August 16, 2011. During this interview, he informed the Nelsons of the victim's head injuries and broken ribs and asked them how these injuries could have occurred. Pursell said that Gregory Nelson's attitude was "just nonchalant" and that Tina Nelson never showed any type of emotion. Although he had seen Gregory and Tina Nelson crying at the hospital the day of the victim's death, he ...

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